Conjunctival Autografting Combined With Low–Dose Mitomycin C for Prevention of Primary Pterygium Recurrence

Abstract

Abstract: : Purpose: To compare the clinical outcome of pterygium surgery combining intraoperative mitomycin C (MMC) with a free conjunctival autograft, with three other surgical methods of pterygium surgery including intraoperative MMC alone, conjunctival autograft alone, and bare sclera without adjunctive treatment. Methods: One hundred and twenty patients underwent pterygium excision surgery. These patients were divided into 4 treatment groups. In group 1 (30 patients) 0.2 mg/ml MMC was applied for three minutes. In group 2 (30 patients) conjunctival autografting was performed. Group 3 (30 patients) received 0.9%NaCl only leaving the sclera bare, and group 4 (30 patients) underwent conjunctival autografting combined with one minute application of 0.2 mg/ml MMC. Results: Pterygium recurred in 2 patients (6.6%) in group 1, in 6 patients (13.3%) in group 2, in 14 patients (46.6%) in group 3 and in none of the patients in group 4. Chi–square analysis revealed a significantly lower recurrence rate when group 4 was compared with group 2 (p=0.038) and with group 3 (p<0.0001). Epithelialization of the wounds was complete within 14 days of surgery. No complications were demonstrated in any of the study groups except one case of minor melting of the flap in group 4. Conclusions: This study indicates that pterygium excision with a free conjunctival autograft combined with intraoperative low–dose MMC is a safe and effective technique for prevention of recurrence of a primary pterygium.

Keywords: Pterygium • conjunctiva • cornea: clinical science